In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a leading place.
Gonarthrosis or arthrosis of the knee joint is a disease associated with the slow destruction of the cartilage tissue of the joint and involves the entire joint in the pathological process, including ligaments, synovial membrane, subchondral bone and other elements of the joint.
Under the influence of various factors such as infectious diseases (cold, flu, typhoid fever, tuberculosis, syphilis, sore throat and many others), injuries, functional overload of the joint (for example, athletes, workers with heavy physical work, ballet dancers), the trophism (nutrition) of the cartilage tissue of the knee joint is disrupted, as a result of which the cartilage becomes thinner and destroyed, sometimes to the point of complete disappearance.
Who is at risk?Firstly, women over forty are at risk of developing arthrosis of the knee joint;It occurs 2 times more often in them than in the stronger half of humanity.In addition, the risk increases in women who tend to be overweight or obese.
But by and large, gonarthrosis is a disease of older people.And there is a simple explanation for this.As you know, cartilage tissue consists of about 70-80% water, which makes it well absorbed.In addition, “regenerating” cells, chondrocytes, actively work at a young age.With age, the amount of moisture begins to decrease and, as a result, the ability to cushion the joint decreases, the cartilage becomes dry, brittle and cracks, and the existing chondrocytes do not have time to repair damage.This largely explains the occurrence of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors include obesity, physical inactivity, chronic joint injury or systematic microtrauma of the joint, alcohol abuse, chronic stress, previous or existing diseases of the knee joint, such as:
- knee arthritis,
- sprain, partial or complete ligament tear,
- intra-articular fracture of the femur or tibia,
- Metabolic disorders, for example gout, and a number of other pathological conditions.
Often there is no clear cause for gonarthrosis of the knee joint;In this case we speak of a combined cause, that is, gonarthrosis was the result of several diseases at the same time.
Also, depending on the reasons for its occurrence, the disease is usually divided into two forms: primary and secondary.
The cause of primary arthrosis is age and the presence of associated factors such as:
- professional disposition,
- Overweight
- Obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis can be a previous injury to the knee (fracture, rupture of the ligamentous apparatus), a so-called post-traumatic osteoarthritis of the knee joint.The cause can also be a previous infectious disease or inflammation of the knee joint.
Symptoms
Signs of osteoarthritis of the knee joint do not appear overnight;The disease develops gradually and often lasts several months or even years.The pain that appears is constant and is aggravated by physical activity - walking, running, climbing stairs, etc.Another characteristic symptom of this disease is the presence of crepitus in the joint, which can be a cracking or grinding sound in the knee.
Other very common manifestations of gonarthrosis are:
- Increase in local temperature (the joint feels hot) or general,
- the presence of swelling of the joint,
- increase its volume,
- difficulty moving,
- Deformation of the joint with subsequent curvature of the limb.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to start defending itself.This is manifested by the growth of bone tissue on the bones forming the joint in the form of “spikes” (osteophytes) and deforming arthrosis of the knee joint occurs.Exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, several degrees of gonarthrosis are distinguished:
- Gonarthrosis of the 1st degree.Patients experience stiffness and mild pain in the joint in the morning or when sitting or standing for long periods of time.At this stage, there is no deformation of the joint and mobility is completely retained.An x-ray shows a small osteophyte.
- Gonarthrosis of the 2nd degree.Painful sensations occur not only in the morning, but also after prolonged exercise;The joint deforms, the articular surfaces enlarge, which also increases the volume of the joint, bending becomes difficult and a crunch is felt when performing movements.A pronounced osteophyte can be seen in the x-ray; the joint space is not changed.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms become more obvious.The pain is constant and does not subside even with rest and sleep.The function of the joint is almost completely lost;Patients cannot bend or straighten their leg.The result is lameness, movement is only possible with crutches or aids.There is a severe deformation of the knee joint.An x-ray shows a slight narrowing of the joint space.
- There is also a fourth stage, in which there is complete immobilization of the affected joint with further deformation.X-rays show sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of arthrosis of the knee joint
To achieve good treatment results, you should contact a qualified rheumatologist, and if he is not there, a therapist, as he knows how to cure arthrosis of the knee joint.In no case should you try to treat the disease yourself, as this can only worsen the already bad situation.Before starting treatment, it is extremely important to make a correct diagnosis, as correct diagnosis is the key to successful treatment.
Treatment of knee arthrosis is a rather lengthy process and depends on a number of factors (type of arthrosis, cause of arthrosis, degree of the disease).Treatment is complex and includes drug and non-drug therapy, in some cases surgical treatment is indicated.
Drug treatment of arthrosis of the knee joint is primarily aimed at alleviating the main manifestations of the disease, such as:
- Pain;
- Inflammation of the joint and periarticular tissue.
In addition to relieving the symptoms of the disease, medications are used to:
- restoration of joint tissue,
- improving trophism and blood circulation,
- Strengthening the body's own defenses,
- Elimination of allergic reactions.
Various non-narcotic analgesics are used to relieve pain symptoms;In rare cases, narcotic painkillers are prescribed for a short period of time.The most commonly used medications belong to the group of non-steroidal anti-inflammatory drugs.They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilage tissue and improve joint mobility.The drugs stimulate the activity of cartilage cells - chondrocytes - and help them restore tissue.Intra-articular administration of chodroprotectors has a good effect.In recent years, a new, effective product based on hyaluronic acid has appeared.Due to its effect, this drug is called a “liquid prosthesis”.After being injected into a painful joint, this medication forms a protective film on the damaged cartilage and gradually restores the joint's normal lubricating properties.
Muscle relaxants are used to relieve muscle spasms;In addition to their relaxing effect, they have a positive effect on blood circulation in the affected joint.
Among non-drug methods of treating gonarthrosis, manual and physical therapy are widely used.Of paramount importance are magnetic therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others.Methods such as laser therapy and cryotherapy (exposure to liquid nitrogen) have recently been used in the treatment of osteoarthritis.In addition to physiotherapy, exercise therapy also has a good effect on osteoarthritis of the knee joint.Movement therapy refers to the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the beginning of the disease, physical stress on the affected joint should be kept to a minimum.You should not run, jump, lift weights, walk quickly, or squat.Exercises for osteoarthritis of the knee joint can only be performed after completing treatment under the supervision of your treating doctor.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but do not lead to excessive mobility of the joint.That is, exercises should be performed with minimal dynamic activity.It is useful to perform exercises to stretch the ligaments and joint capsules.The rules here are the same: perform the exercises gently and without strain.
When doing any gymnastics exercises, it is important to follow a few rules:
- Do not perform exercises while overcoming pain.
- If an exercise causes pain, it should be replaced with a gentler one.
Massage for arthrosis of the knee joint has a positive effect on restoring the functions of the knee joint.At the site of exposure, blood vessels expand, blood circulation improves, and metabolism accelerates.Massage procedures improve lymph flow, which in turn helps eliminate residual inflammation.Massage strengthens muscles, increases oxygen flow, improves gas exchange, normalizes tone and increases plasticity.
Diet for arthrosis of the knee joint
Medical experts have recently found that there is no direct connection between the frequency of knee osteoarthritis and diet.However, an indisputable fact is that the development of osteoarthritis largely depends on the presence of excess weight in humans.If the cause of the disease was precisely excess weight, it is obvious that the diet for arthrosis of the knee joint should be aimed at gradually reducing body weight.This requires a change in diet and diet.Foods should be lower in calories, fried foods and foods with a high fat content should be excluded from the diet.Eat more vegetables, fruits and fluids.
Prevention of osteoarthritis of the knee joint
In order for your joints to stay healthy for as long as possible, it is necessary to exercise and do gymnastics regularly, but you should not get too involved in it so that the joints do not become overloaded.Swimming offers the best effect and minimal stress on the joints.If you play professional sports, you must use joint protection.It makes sense to alternate physical activity with rest;You should not remain immobile for long periods of time.
Compliance with all these simple rules, coupled with a healthy lifestyle and proper nutrition, will not lead to arthrosis of the knee joint ruining a person's life.